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Atrial fibrillation
- Source :
- Clinical Research in Cardiology. 95:148-153
- Publication Year :
- 2006
- Publisher :
- Springer Science and Business Media LLC, 2006.
-
Abstract
- OBJECTIVE Patients with atrial fibrillation (AF) have a risk of cerebral embolism. Echocardiographic parameters elevate this risk significantly. However, there is little knowledge about the long-term fate and the rate of clinically silent cerebral embolism under continued oral anticoagulation. The aims of our study were to assess prognosis of patients with AF and determine a high risk group with an increased risk of cerebral embolism under oral anticoagulation. METHODS Consecutive patients with persistent or permanent AF and left atrial (LA) thrombi, dense spontaneous echo contrast (SEC) and/or reduced LA appendage peak emptying velocities (LAAv) were included in the study (N = 128). Patients with AF and without echocardiographic risk factors (N = 114) served as controls. All patients were examined with transesophageal echocardiography, cranial magnetic resonance imaging and clinically during a period of three years. RESULTS During the three-year follow-up period 6 (5%) of the high risk patients had cerebral embolism with neurological deficits. 4 (3%) patients died due to embolic events and 17 (13%) patients had silent embolism as documented on MRI. In the control group 8 (7%) patients had embolic events (n = 1 clinically apparent and n = 7 silent embolism) documented on MRI, one was clinically apparent. Study patients with an event had more commonly previous thromboembolism (p < 0.0001). CONCLUSIONS Patients with peristent or permanent AF and LA thrombi, dense SEC or reduced LAAv have an explicitly increased risk of cerebral embolism (21%) despite oral anticoagulation. Previous thromboembolic event is another important predictor for an event.
- Subjects :
- Male
medicine.medical_specialty
Comorbidity
Risk Assessment
Risk groups
Cerebral embolism
Risk Factors
Left atrial
Germany
Internal medicine
Atrial Fibrillation
medicine
Humans
High risk patients
medicine.diagnostic_test
business.industry
Incidence
Atrial fibrillation
Magnetic resonance imaging
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Increased risk
Intracranial Embolism
Embolism
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Echocardiography, Transesophageal
Subjects
Details
- ISSN :
- 18610692 and 18610684
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Clinical Research in Cardiology
- Accession number :
- edsair.doi.dedup.....7c106f3027b2a688d06af17e7f2497a2